Provider Demographics
NPI:1982034104
Name:SMITH, DYLANA (MS, AGPCNP-BC, HNP)
Entity Type:Individual
Prefix:
First Name:DYLANA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, AGPCNP-BC, HNP
Other - Prefix:
Other - First Name:DYLANA
Other - Middle Name:
Other - Last Name:POSSIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, AGPCNP-BC, HNP
Mailing Address - Street 1:401 THIRD AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1117
Mailing Address - Country:US
Mailing Address - Phone:609-865-7616
Mailing Address - Fax:
Practice Address - Street 1:1275 YORK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6007
Practice Address - Country:US
Practice Address - Phone:212-639-6093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF306521-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health